Unexpected weight loss is a symptom that can be attributed to multiple health conditions. The likelihood of most of these conditions increases with age due to frailty. The following paper describes a recommended course of actions for a patient with complaints of weight loss, exhaustion, and a decline in physical strength.
In order to determine the causes of the reported condition, the patient is to be asked several additional questions. First, it is important to acknowledge that unintentional weight loss can occur as a result of experiencing a stressful event. Thus, an inquiry is recommended regarding the recent experiences that could have resulted in a major emotional response. The patient’s family can be involved at this stage since the patient may omit important information. Next, it is recommended to ask the patient about the presence of chronic conditions such as diabetes and gastrointestinal disorders, both of which can result in weight loss after an increase in severity. Finally, in some cases, the development of cancer is associated with weight loss. Thus, the patient should be asked about his general well-being and the presence of other symptoms that may help to determine the direction of further inquiry.
In some cases, weight loss and fatigue result from the exacerbation of the existing chronic conditions. Therefore, it is also recommended to conduct several screenings to account for such a possibility. First, according to a study by Saha, Hatch, Hayden, Steffens, and Potter (2016), “Higher scores on the appetite and weight loss symptom factor were associated with an increased hazard of both AD and non-AD dementia” (p. 870). Therefore, it would be necessary to conduct a physical exam and run several diagnostic tests in order to detect the possible onset of a mental disorder. In addition, it is recommended to conduct a blood test for celiac disease which is known to result in similar symptoms. Next, a test for diabetes may be necessary in order to rule out the attribution of symptoms to the condition. Finally, it is necessary to screen for infectious diseases such as hepatitis and HIV since both conditions produce similar effects.
In addition to a number of single-system illnesses that may be considered potential candidates for the reported complaints, frailty should be considered as a possible primary cause. Defined as “a state of vulnerability to poor resolution of homoeostasis after a stressor event,” frailty is associated with a gradual decline of overall health that does not necessarily localize in a specific system (Clegg, Young, Iliffe, Rikkert, & Rockwood, 2013, p. 752). The main reason frailty needs to be considered as a possible cause of complaint is the patient’s age. The occurrence of frailty is known to increase with old age, and the cumulative effect of homeostatic reserves depletion leads to a gradual increase of adverse health effects (Clegg et al., 2013). In addition, it is worth pointing out that the breadth of symptoms (decreased physical strength, weight loss, and exhaustion) is also consistent with the diagnosis.
Considering the information above, it would be reasonable to recommend a referral to home and community care. The primary reason is the statement by the patient that he lives alone. The reported decline in strength is expected to create significant difficulties for self-management and, in extreme cases, may eventually result in health-threatening condition (e.g. the inability of the patient to sustain himself). The patient can also be referred to geriatric services. However, it is important to acknowledge the patient’s reluctance to leave his home, which limits the range of available options.
Aging is associated with the emergence of numerous health issues. However, the majority of the said issues can be addressed through management. Thus, timely screening is necessary to prevent or minimize adverse health effects and increase health-related quality of life, as illustrated in the case study.
References
Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013). Frailty in elderly people. The Lancet, 381(9868), 752-762.
Saha, S., Hatch, D. J., Hayden, K. M., Steffens, D. C., & Potter, G. G. (2016). Appetite and weight loss symptoms in late-life depression predict dementia outcomes. The American Journal of Geriatric Psychiatry, 24(10), 870-878.